Anderson Brady J, Allen David Z, McKee Sean P, Low Garren, Yuksel Sancak
Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, TX, USA.
J Surg Case Rep. 2021 Dec 11;2021(12):rjab467. doi: 10.1093/jscr/rjab467. eCollection 2021 Dec.
Postpartum psychosis (PPP) is a severe mood disorder following childbirth that rarely leads to injurious or suicidal behavior. This report illustrates otolaryngologic intervention for pharyngeal laceration and airway instability following traumatic foreign body ingestion in the setting of PPP. A 25-year-old woman with PPP presented with hemoptysis after attempting suicide by traumatically forcing tree branches into her oropharynx. Imaging revealed pneumomediastinum, and flexible laryngoscopy and esophagoscopy showed a large foreign body (tree branch) extending from the hypopharynx to the gastroesophageal junction. She was taken to the operating room for direct microlaryngoscopy, bronchoscopy and esophagoscopy with removal of the 25-cm tree branch. Panendoscopy revealed a mucosal laceration at the cricopharyngeus with supraglottic and hypopharyngeal edema but no injury to the larynx. Due to airway concerns, a cuffed tracheostomy was placed along with a gastrostomy tube for feeding access. She tolerated her postoperative course with successful decannulation and oral feeding prior to discharge.
产后精神病（PPP）是一种产后严重的情绪障碍，很少导致伤害或自杀行为。本报告阐述了在产后精神病背景下，针对外伤性异物摄入后咽部撕裂和气道不稳定的耳鼻喉科干预措施。一名患有产后精神病的25岁女性，在试图通过将树枝强行插入口咽自杀后出现咯血。影像学检查显示纵隔气肿，纤维喉镜和食管镜检查发现一个大的异物（树枝）从下咽延伸至胃食管交界处。她被送往手术室进行直接显微喉镜检查、支气管镜检查和食管镜检查，并取出了25厘米长的树枝。全内镜检查显示环状咽肌处有黏膜撕裂，声门上和下咽水肿，但喉部未受损伤。出于气道方面的考虑，放置了带气囊的气管造口管，并置入胃造口管用于进食。她术后恢复良好，出院前成功拔管并开始经口进食。
